A Case of Endogenous Klebsiella Endophthalmitis Associated with Acute Pyelonephritis in a Patient with Chronic Renal Failure

Korean Journal of Nephrology 2009;28(3):253-258.

In Hee Lee, M.D.1, Tae Won Kim, M.D.1, Gun Woo Kang, M.D.1, Young Chan Park, M.D.2, Keun Hae Kim, M.D.3 and Yun Young Kim, M.D.3

Departments of Internal Medicine¹
Radiology²
Ophthalmology³
Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : 만성 신부전 환자에서 발생한 급성 신우신염에 합병된 내인성 Klebsiella 안내염 1예

이인희1, 김태원1, 강건우1, 박영찬2, 김근해3, 김윤영3

대구가톨릭대학교 의과대학 내과학교실1, 영상의학과교실2, 안과학교실3

Abstract

Endogenous endophthalmitis is any inflammation of the internal ocular space that usually has a poor prognosis for visual recovery, and is a rare complication of Klebsiella pneumoniae septicemia. We report here a case of endogenous endophthalmitis due to K. pneumoniae in a patient with acute pyelonephritis and chronic renal failure who did not have any history of diabetes mellitus. A 75-year-old woman was admitted to our hospital, complaining of severe pain and decreased vision in the right eye, accompanied by fever and nausea, of 48 hours’ duration. Ophthalmologic evaluation and intervention were performed. Blood, urine and vitreous cultures were all positive for K. pneumoniae. She was treated with intravenous antibiotics, intravitreal antibiotics injection and pars plana vitrectomy. However, her right eye showed progressive worsening to enucleation, and she has been on maintenance hemodialysis ever since.

Key Words: Endophthalmitis, Pyelonephritis, Kidney failure, chronic